Provider Demographics
NPI:1104885391
Name:BORGES RUIZ, LOURDES R (MD)
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:R
Last Name:BORGES RUIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-853-8800
Mailing Address - Fax:612-371-1732
Practice Address - Street 1:535 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:WI
Practice Address - Zip Code:54017-1449
Practice Address - Country:US
Practice Address - Phone:715-243-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN41445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN72Q29BOOtherBCBS
MN886433100Medicaid
MNHP30919OtherHEALTH PARTNERS
MNP00401953OtherMEDICARE RAILROAD
MNNA9021025215OtherPREFERRED ONE
MN0105295OtherMEDICA
MN886433100OtherMN HEALTH PLAN
MN160432OtherUCARE
MN160432OtherUCARE
MN886433100Medicaid